资源描述：
《Acute Type A Aortic Dissection 中老年的临床特点.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、JournaloftheAmericanCollegeofCardiologyVol.40,No.4,2002©2002bytheAmericanCollegeofCardiologyFoundationISSN0735-1097/02/$22.00PublishedbyElsevierScienceInc.PIIS0735-1097(02)02005-3AorticDissectionAcuteTypeAAorticDissectionintheElderly:ClinicalCharacteristics,Man
2、agement,andOutcomesintheCurrentEraRajendraH.Mehta,MD,FACC,MS,*PatrickT.OGara,MD,FACC,EduardoBossone,MD,ChristophA.Nienaber,MD,FACC,§TrulsMyrmel,MD,JeannaV.Cooper,MS,*DeanE.Smith,PHD,*WilliamF.Armstrong,MD,FACC,*EricM.Isselbacher,MD,FACC,¶LindaA.Pape,MD,FACC,#K
3、imA.Eagle,MD,FACC,*DanGilon,MD,FACC,**onbehalfoftheInternationalRegistryofAcuteAorticDissection(IRAD)InvestigatorsAnnArbor,Michigan;BostonandWorcester,Massachusetts;SanDonato,Italy;Rostock,Germany;Tromsø,Norway;andJerusalem,IsraelOBJECTIVESWesoughttoevaluatethe
4、clinicalcharacteristics,management,andoutcomesofelderlypatientswithacutetypeAaorticdissection.BACKGROUNDFewdataexistontheclinicalmanifestationsandoutcomesofacutetypeAaorticdissectioninanelderlypatientcohort.METHODSWecategorized550patientswithtypeAaorticdissecti
5、onenrolledintheInternationalRegistryofAcuteAorticDissectionintotwoagestrata(70and70years)andcomparedtheirclinicalfeatures,management,andin-hospitalevents.RESULTSThirty-twopercentofpatientswithtypeAdissectionwereaged70years.Marfansyndromewasexclusivelyassocia
6、tedwithdissectionintheyoung,whereashypertension,atherosclerosisandiatrogenicdissectionpredominatedinolderpatients.Typicalsymptoms(abruptonsetofchestorbackpain)andsigns(aorticregurgitationmurmurorpulsedeficits)ofdissectionwerelesscommonamongtheelderly.Fewerelderl
7、ypatientsweremanagedsurgicallythanyoungerpatients(64%vs.86%,p0.0001).Hypotensionoccurredmorefrequently(46%vs.32%,p0.002)andfocalneurologicdeficitslessfrequently(18%vs.26%,p0.04)amongtheelderly.In-hospitalmortalitywashigheramongolderpatients(43%vs.28%,p0.0006
8、).Logisticregressionanalysisidentifiedage70yearsasanindependentpredictorofhospitaldeathforacutetypeAaorticdissection(oddsratio1.7,95%confidenceinterval1.12.8;p0.03).CONCLUSI
